Literature DB >> 18439504

Double-contrast barium enema and transrectal endoscopic ultrasonography in the diagnosis of intestinal deeply infiltrating endometriosis.

Helizabet Salomão Abdalla Ayroza Ribeiro1, Paulo Ayroza Ribeiro, Lucio Rossini, Francisco Cesar Rodrigues, Nilson Donadio, Tsutomu Aoki.   

Abstract

STUDY
OBJECTIVE: To evaluate the sensitivity, specificity, negative predictive value, positive predictive value, association, and agreement of double-contrast barium enema (DCBE) and transrectal endoscopic ultrasonography (Tr EUS) in the diagnosis of rectosigmoid colon endometriosis.
DESIGN: Prospective nonrandomized (Canadian Task Force classification II-2).
SETTING: University hospital. PATIENTS: We evaluated 37 patients with clinically suspected deeply infiltrating endometriosis (DIE) from January 2004 through January 2005.
INTERVENTIONS: Clinical examination, DCBE, Tr EUS, and laparoscopy for histologic confirmation.
MEASUREMENTS AND MAIN RESULTS: Deeply infiltrating endometriosis was confirmed by laparoscopic visualization and by histopathologic examination in all patients. Intestinal endometriosis was observed in 27 patients (72.9%). DCBE showed abnormalities suggestive of bowel endometriosis in 24 patients (64.9%) and Tr EUS in 28 patients (75.7%). Considering the DCBE findings we observed among the 24 abnormal examination results, 16 (42.3%) had spiculation, 16 (42.3%) had circumferential narrowing of the bowel, and 4 (10.8%) had the mass effect sign. For DCBE the sensitivity was 88%, the specificity was 54%, the negative predictive value (NPV) was 70%, and the positive predictive value (PPV) was 78%. For Tr EUS the sensitivity, specificity, NPV, and PPV were 96%, 100%, 90%, and 100%. A significant association of the DCBE and the Tr EUS in the diagnosis of intestinal DIE (p = .017) and a moderate agreement of the methods (kappa = 0.44) was also observed.
CONCLUSION: Our data, although limited by sample size, confirmed that DCBE has a good sensitivity and a low specificity in the diagnosis of intestinal DIE. The Tr EUS proved to have a higher sensitivity and specificity with elevated NPV and PPV. A significant association of the DCBE and the Tr EUS in the diagnosis of intestinal DIE and a moderate agreement of the methods was also observed.

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Year:  2008        PMID: 18439504     DOI: 10.1016/j.jmig.2008.02.001

Source DB:  PubMed          Journal:  J Minim Invasive Gynecol        ISSN: 1553-4650            Impact factor:   4.137


  12 in total

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Review 10.  Transrectal ultrasound - Techniques and outcomes in the management of intestinal endometriosis.

Authors:  Lucio G B Rossini; Paulo A A G Ribeiro; Francisco C M Rodrigues; Sheila S Filippi; Rodrigo de R Zago; Nutianne C Schneider; Luciano Okawa; Wilmar A Klug
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